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The prevalence and factors influencing postnatal depression in a rural community

Abrahams, Johanna Magdalena (2011-12)

Thesis (MCur)--Stellenbosch University, 2011.

Thesis

ENGLISH ABSTRACT: Mental health is still the step-child of Health Services, although many studies show the serious
negative impact it has on the mother, baby and the family.
Knowledge about Postnatal Depression (PND) and associated risk factors which influence the
development of PND is vital for early detection and intervention.
Worldwide PND affects on average 10-15% of women after giving birth regardless of socio-economic
status, race or education. Studies also reveal that the prevalence of PND is as high
as 40-60% amongst women after giving birth.
The goal of the study was to investigate the prevalence and factors influencing PND in a rural
setting, in the Witzenberg Sub-district. The objectives included determining the prevalence of
PND and identifying the contributing risk factors associated with PND.
A descriptive explorative research design with a quantitative approach was applied. The target
population was (N=1605) mothers, 18 years and older who gave birth in this Sub-district in one
year, a convenience sampling method was used to select the study sample of (n=159/10%)
participants who met the criteria and who gave voluntary permission to take part in the study.
Validity and reliability was supported through the use of validated questionnaires EPDS and BDI
including a questionnaire based on demographical, psychosocial and obstetrical data. In
addition experts in statistics, nursing and psychiatry were consulted including language experts
who validated the correctness of the Afrikaans and Xhosa translated questionnaires. A pilot
study was conducted to test the feasibility of the study and all data was collected personally by
the researcher with the support of two trained field workers.
Ethics approval was obtained from Stellenbosch University and permission from the Department
of Health, Provincial Government of the Western Cape, including informed written consent from
each participant.
The data was analysed with the assistance of a statistician and are presented with histograms
and frequency tables. The relationship between continuous response variables and nominal
input variables was analysed using analysis of variance (ANOVA). Various statistical tests were
applied to determine statistical associations between variables such as the chi-square tests using a 95% confidence interval. Non-parametric tests such as the Mann-Whitney U–test or
Kruskal-Wallis test were used for randomised design. Levene’s test was used for Homogeneity
of Variance and the Bonferonni test of probability.
The study revealed that 50.3% of the mothers, who participated in the study, had PND. Various
risk factors were determined in this study that influences the development of PND. Results
include statistical associations between PND and the following:
- unplanned babies and unwelcome babies (p=<0,01)
- life events (p=0.01)
- partner relationship (p=<0.01)
- family and social support (p=<0.1)
Furthermore, the majority of the participants (53.8%) with PND (n=80) had a history of a
psychiatric illness which was shown with significance (p=<0.01), the majority of the participants
(63.5%) were unmarried and 23.8% were teenagers who suffered from PND.
Recommendations include promoting healthy lifestyles, empowerment of women, prevention of
teenage pregnancies, early and holistic assessment for symptoms of PND and approriate
referral.
In conclusion the prevention and promotive measures, early detection of PND and appropriate
referrals and treatment are critical in managing maternal, child and family well being.